Brain–computer interface

A brain-computer interface (BCI), sometimes called a neural-control interface (NCI), mind-

machine interface (MMI), direct neural interface (DNI), or brain-machine interface (BMI),
is a direct communication pathway between an enhanced or wired brain and an external device. BCI
differs from neuromodulation in that it allows for bidirectional information flow. BCIs are often directed
at researching, mapping, assisting, augmenting, or repairing human cognitive or sensory-motor
functions.[1]

Research on BCIs began in the 1970s at the University of California, Los Angeles (UCLA) under a grant
from the National Science Foundation, followed by a contract from DARPA.[2][3] The papers published
after this research also mark the first appearance of the expression brain–computer interface in
scientific literature.

Due to the cortical plasticity of the brain, signals from implanted prostheses can, after adaptation, be
handled by the brain like natural sensor or effector channels.[4] Following years of animal
experimentation, the first neuroprosthetic devices implanted in humans appeared in the mid-1990s.

Recently, studies in Human-computer interaction through the application of machine learning with
statistical temporal features extracted from the frontal lobe, EEG brainwave data has shown high levels
of success in classifying mental states (Relaxed, Neutral, Concentrating),[5] mental emotional states
(Negative, Neutral, Positive)[6] and thalamocortical dysrhythmia.[7]

Contents
History
BCIs versus neuroprosthetics
Animal BCI research
Early work
Prominent research successes
Kennedy and Yang Dan
Nicolelis
Donoghue, Schwartz and Andersen
Other research
The BCI Award
Human BCI research
Invasive BCIs
Vision
Movement
Partially invasive BCIs
Non-invasive BCIs
Non-EEG-based human–computer interface
Functional near-infrared spectroscopy
 Electroencephalography (EEG)-based brain-computer interfaces
Dry active electrode arrays
SSVEP mobile EEG BCIs
Limitations
Prosthesis and environment control
DIY and open source BCI
MEG and MRI
BCI control strategies in neurogaming
Synthetic telepathy/silent communication
Cell-culture BCIs
Ethical considerations
User-centric issues
Legal and social
Low-cost BCI-based interfaces
Future directions
Disorders of consciousness (DOC)
Motor recovery
Functional brain mapping
Flexible devices
Neural dust
See also
Notes
References
Further reading
External links

History
The history of brain–computer interfaces (BCIs) starts with Hans Berger's discovery of the electrical
activity of the human brain and the development of electroencephalography (EEG). In 1924 Berger was
the first to record human brain activity by means of EEG. Berger was able to identify oscillatory activity,
such as Berger's wave or the alpha wave (8–13 Hz), by analyzing EEG traces.

Berger's first recording device was very rudimentary. He inserted silver wires under the scalps of his
patients. These were later replaced by silver foils attached to the patient's head by rubber bandages.
Berger connected these sensors to a Lippmann capillary electrometer, with disappointing results.
However, more sophisticated measuring devices, such as the Siemens double-coil recording
galvanometer, which displayed electric voltages as small as one ten thousandth of a volt, led to success.

Berger analyzed the interrelation of alternations in his EEG wave diagrams with brain diseases. EEGs
permitted completely new possibilities for the research of human brain activities.
Although the term had not yet been coined, one of the earliest examples of a working brain-machine
interface was the piece Music for Solo Performer (1965) by the American composer Alvin Lucier. The
piece makes use of EEG and analog signal processing hardware (filters, amplifiers, and a mixing board)
to stimulate acoustic percussion instruments. To perform the piece one must produce alpha waves and
thereby "play" the various percussion instruments via loudspeakers which are placed near or directly on
the instruments themselves.[8]

UCLA Professor Jacques Vidal coined the term "BCI" and produced the first peer-reviewed publications
on this topic.[2][3] Vidal is widely recognized as the inventor of BCIs in the BCI community, as reflected
in numerous peer-reviewed articles reviewing and discussing the field (e.g.,[9][10][11]). His 1973 paper
stated the "BCI challenge": Control of external objects using EEG signals. Especially he pointed out to
Contingent Negative Variation (CNV) potential as a challenge for BCI control. The 1977 experiment Vidal
described was the first application of BCI after his 1973 BCI challenge. It was a noninvasive EEG
(actually Visual Evoked Potentials (VEP)) control of a cursor-like graphical object on a computer screen.
The demonstration was movement in a maze.[12]

After his early contributions, Vidal was not active in BCI research, nor BCI events such as conferences,
for many years. In 2011, however, he gave a lecture in Graz, Austria, supported by the Future BNCI
project, presenting the first BCI, which earned a standing ovation. Vidal was joined by his wife, Laryce
Vidal, who previously worked with him at UCLA on his first BCI project.

In 1988, a report was given on noninvasive EEG control of a physical object, a robot. The experiment
described was EEG control of multiple start-stop-restart of the robot movement, along an arbitrary
trajectory defined by a line drawn on a floor. The line-following behavior was the default robot behavior,
utilizing autonomous intelligence and autonomous source of energy.[13][14] This 1988 report written by
Stevo Bozinovski, Mihail Sestakov, and Liljana Bozinovska was the first one about a robot control using
EEG.[15][16]

In 1990, a report was given on a closed loop, bidirectional adaptive BCI controlling computer buzzer by
an anticipatory brain potential, the Contingent Negative Variation (CNV) potential.[17][18] The
experiment described how an expectation state of the brain, manifested by CNV, controls in a feedback
loop the S2 buzzer in the S1-S2-CNV paradigm. The obtained cognitive wave representing the
expectation learning in the brain is named Electroexpectogram (EXG). The CNV brain potential was part
of the BCI challenge presented by Vidal in his 1973 paper.

BCIs versus neuroprosthetics

Neuroprosthetics is an area of neuroscience concerned with neural prostheses, that is, using artificial
devices to replace the function of impaired nervous systems and brain-related problems, or of sensory
organs or organs itself (bladder, diaphragm, etc). As of December 2010, cochlear implants had been
implanted as neuroprosthetic device in approximately 220,000 people worldwide.[19] There are also
several neuroprosthetic devices that aim to restore vision, including retinal implants. The first
neuroprosthetic device, however, was the pacemaker.

The terms are sometimes used interchangeably. Neuroprosthetics and BCIs seek to achieve the same
aims, such as restoring sight, hearing, movement, ability to communicate, and even cognitive function.[1]
Both use similar experimental methods and surgical techniques.

Animal BCI research

Several laboratories have managed to record signals from monkey and rat cerebral cortices to operate
BCIs to produce movement. Monkeys have navigated computer cursors on screen and commanded
robotic arms to perform simple tasks simply by thinking about the task and seeing the visual feedback,
but without any motor output.[20] In May 2008 photographs that showed a monkey at the University of
Pittsburgh Medical Center operating a robotic arm by thinking were published in a number of well-
known science journals and magazines.[21]

Early work

In 1969 the operant conditioning studies of Fetz and colleagues, at

the Regional Primate Research Center and Department of
Physiology and Biophysics, University of Washington School of
Medicine in Seattle, showed for the first time that monkeys could
learn to control the deflection of a biofeedback meter arm with
neural activity.[22] Similar work in the 1970s established that
monkeys could quickly learn to voluntarily control the firing rates of Monkey operating a robotic arm with
individual and multiple neurons in the primary motor cortex if they brain–computer interfacing
were rewarded for generating appropriate patterns of neural (Schwartz lab, University of
activity.[23] Pittsburgh)

Studies that developed algorithms to reconstruct movements from

motor cortex neurons, which control movement, date back to the 1970s. In the 1980s, Apostolos
Georgopoulos at Johns Hopkins University found a mathematical relationship between the electrical
responses of single motor cortex neurons in rhesus macaque monkeys and the direction in which they
moved their arms (based on a cosine function). He also found that dispersed groups of neurons, in
different areas of the monkey's brains, collectively controlled motor commands, but was able to record
the firings of neurons in only one area at a time, because of the technical limitations imposed by his
equipment.[24]

There has been rapid development in BCIs since the mid-1990s.[25] Several groups have been able to
capture complex brain motor cortex signals by recording from neural ensembles (groups of neurons) and
using these to control external devices.

Prominent research successes

Kennedy and Yang Dan

Phillip Kennedy (who later founded Neural Signals in 1987) and colleagues built the first intracortical
brain–computer interface by implanting neurotrophic-cone electrodes into monkeys.

In 1999, researchers led by Yang Dan at the University of California, Berkeley decoded neuronal firings
to reproduce images seen by cats. The team used an array of electrodes embedded in the thalamus
(which integrates all of the brain's sensory input) of sharp-eyed cats. Researchers targeted 177 brain cells
in the thalamus lateral geniculate nucleus area, which decodes signals from the retina. The cats were
shown eight short movies, and their neuron firings were recorded. Using mathematical filters, the
researchers decoded the signals to generate movies of what the cats saw and were able to reconstruct
recognizable scenes and moving objects.[26] Similar results in humans have since been achieved by
researchers in Japan (see below).
Nicolelis

Miguel Nicolelis, a professor at Duke University, in Durham, North

Carolina, has been a prominent proponent of using multiple
electrodes spread over a greater area of the brain to obtain neuronal
signals to drive a BCI.

After conducting initial studies in rats during the 1990s, Nicolelis Yang Dan and colleagues'
and his colleagues developed BCIs that decoded brain activity in owl recordings of cat vision using a BCI
implanted in the lateral geniculate
monkeys and used the devices to reproduce monkey movements in
nucleus (top row: original image;
robotic arms. Monkeys have advanced reaching and grasping
bottom row: recording)
abilities and good hand manipulation skills, making them ideal test
subjects for this kind of work.

By 2000, the group succeeded in building a BCI that reproduced owl monkey movements while the
monkey operated a joystick or reached for food.[27] The BCI operated in real time and could also control
a separate robot remotely over Internet protocol. But the monkeys could not see the arm moving and did
not receive any feedback, a so-called open-loop BCI.

Later experiments by Nicolelis using rhesus monkeys succeeded in

closing the feedback loop and reproduced monkey reaching and
grasping movements in a robot arm. With their deeply cleft and
furrowed brains, rhesus monkeys are considered to be better models
for human neurophysiology than owl monkeys. The monkeys were
trained to reach and grasp objects on a computer screen by
manipulating a joystick while corresponding movements by a robot
arm were hidden.[28][29] The monkeys were later shown the robot
directly and learned to control it by viewing its movements. The BCI Diagram of the BCI developed by
used velocity predictions to control reaching movements and Miguel Nicolelis and colleagues for
simultaneously predicted handgripping force. In 2011 O'Doherty and use on rhesus monkeys
colleagues showed a BCI with sensory feedback with rhesus
monkeys. The monkey was brain controlling the position of an
avatar arm while receiving sensory feedback through direct intracortical stimulation (ICMS) in the arm
representation area of the sensory cortex.[30]

Donoghue, Schwartz and Andersen

Other laboratories which have developed BCIs and algorithms that decode neuron signals include those
run by John Donoghue at Brown University, Andrew Schwartz at the University of Pittsburgh and
Richard Andersen at Caltech. These researchers have been able to produce working BCIs, even using
recorded signals from far fewer neurons than did Nicolelis (15–30 neurons versus 50–200 neurons).

Donoghue's group reported training rhesus monkeys to use a BCI to track visual targets on a computer
screen (closed-loop BCI) with or without assistance of a joystick.[31] Schwartz's group created a BCI for
three-dimensional tracking in virtual reality and also reproduced BCI control in a robotic arm.[32] The
same group also created headlines when they demonstrated that a monkey could feed itself pieces of
fruit and marshmallows using a robotic arm controlled by the animal's own brain signals.[33][34][35]

Andersen's group used recordings of premovement activity from the posterior parietal cortex in their
BCI, including signals created when experimental animals anticipated receiving a reward.[36]
Other research

In addition to predicting kinematic and kinetic parameters of limb movements, BCIs that predict
electromyographic or electrical activity of the muscles of primates are being developed.[37] Such BCIs
could be used to restore mobility in paralyzed limbs by electrically stimulating muscles.

Miguel Nicolelis and colleagues demonstrated that the activity of large neural ensembles can predict arm
position. This work made possible creation of BCIs that read arm movement intentions and translate
them into movements of artificial actuators. Carmena and colleagues[28] programmed the neural coding
in a BCI that allowed a monkey to control reaching and grasping movements by a robotic arm. Lebedev
and colleagues[29] argued that brain networks reorganize to create a new representation of the robotic
appendage in addition to the representation of the animal's own limbs.

In 2019, researchers from UCSF published a study where they demonstrated a BCI that had the potential
to help patients with speech impairment caused by neurological disorders. Their BCI used high-density
electrocorticography to tap neural activity from a patient's brain and used deep learning methods to
synthesize speech.[38][39]

The biggest impediment to BCI technology at present is the lack of a sensor modality that provides safe,
accurate and robust access to brain signals. It is conceivable or even likely, however, that such a sensor
will be developed within the next twenty years. The use of such a sensor should greatly expand the range
of communication functions that can be provided using a BCI.

Development and implementation of a BCI system is complex and time consuming. In response to this
problem, Gerwin Schalk has been developing a general-purpose system for BCI research, called
BCI2000. BCI2000 has been in development since 2000 in a project led by the Brain–Computer
Interface R&D Program at the Wadsworth Center of the New York State Department of Health in
Albany, New York, United States.

A new 'wireless' approach uses light-gated ion channels such as Channelrhodopsin to control the activity
of genetically defined subsets of neurons in vivo. In the context of a simple learning task, illumination of
transfected cells in the somatosensory cortex influenced the decision making process of freely moving
mice.[40]

The use of BMIs has also led to a deeper understanding of neural networks and the central nervous
system. Research has shown that despite the inclination of neuroscientists to believe that neurons have
the most effect when working together, single neurons can be conditioned through the use of BMIs to
fire at a pattern that allows primates to control motor outputs. The use of BMIs has led to development
of the single neuron insufficiency principle which states that even with a well tuned firing rate single
neurons can only carry a narrow amount of information and therefore the highest level of accuracy is
achieved by recording firings of the collective ensemble. Other principles discovered with the use of
BMIs include the neuronal multitasking principle, the neuronal mass principle, the neural degeneracy
principle, and the plasticity principle.[41]

BCIs are also proposed to be applied by users without disabilities. A user-centered categorization of BCI
approaches by Thorsten O. Zander and Christian Kothe introduces the term passive BCI.[42] Next to
active and reactive BCI that are used for directed control, passive BCIs allow for assessing and
interpreting changes in the user state during Human-Computer Interaction (HCI). In a secondary,
implicit control loop the computer system adapts to its user improving its usability in general.
Beyond BCI systems that decode neural activity to drive external effectors, BCI systems may be used to
encode signals from the periphery. These sensory BCI devices enable real-time, behaviorally-relevant
decisions based upon closed-loop neural stimulation.[43]

The BCI Award

The Annual BCI Research Award is awarded in recognition of outstanding and innovative research in the
field of Brain-Computer Interfaces. Each year, a renowned research laboratory is asked to judge the
submitted projects. The jury consists of world-leading BCI experts recruited by the awarding laboratory.
The jury selects twelve nominees, then chooses a first, second, and third-place winner, who receive
awards of $3,000, $2,000, and $1,000, respectively.

Human BCI research

Invasive BCIs

Invasive BCI requires surgery to implant electrodes under scalp for communicating brain signals. The
main advantage is to provide more accurate reading; however, its downside includes side effects from
the surgery. After the surgery, scar tissues may form which can make brain signals weaker. In addition,
according to the research of Abdulkader et al., (2015),[44] the body may not accept the implanted
electrodes and this can cause a medical condition.

Vision

Invasive BCI research has targeted repairing damaged sight and providing new functionality for people
with paralysis. Invasive BCIs are implanted directly into the grey matter of the brain during
neurosurgery. Because they lie in the grey matter, invasive devices produce the highest quality signals of
BCI devices but are prone to scar-tissue build-up, causing the signal to become weaker, or even non-
existent, as the body reacts to a foreign object in the brain.[45]

In vision science, direct brain implants have been used to treat non-congenital (acquired) blindness. One
of the first scientists to produce a working brain interface to restore sight was private researcher William
Dobelle.

Dobelle's first prototype was implanted into "Jerry", a man blinded in adulthood, in 1978. A single-array
BCI containing 68 electrodes was implanted onto Jerry's visual cortex and succeeded in producing
phosphenes, the sensation of seeing light. The system included cameras mounted on glasses to send
signals to the implant. Initially, the implant allowed Jerry to see shades of grey in a limited field of vision
at a low frame-rate. This also required him to be hooked up to a mainframe computer, but shrinking
electronics and faster computers made his artificial eye more portable and now enable him to perform
simple tasks unassisted.[46]

In 2002, Jens Naumann, also blinded in adulthood, became the first in a series of 16 paying patients to
receive Dobelle's second generation implant, marking one of the earliest commercial uses of BCIs. The
second generation device used a more sophisticated implant enabling better mapping of phosphenes into
coherent vision. Phosphenes are spread out across the visual field in what researchers call "the starry-
night effect". Immediately after his implant, Jens was able to use his imperfectly restored vision to drive
an automobile slowly around the parking area of the research institute. Unfortunately, Dobelle died in
2004[47] before his processes and developments were documented. Subsequently, when Mr. Naumann
and the other patients in the program began having problems with
their vision, there was no relief and they eventually lost their "sight"
again. Naumann wrote about his experience with Dobelle's work in
Search for Paradise: A Patient's Account of the Artificial Vision
Experiment[48] and has returned to his farm in Southeast Ontario,
Canada, to resume his normal activities.[49]

Movement

BCIs focusing on motor neuroprosthetics aim to either restore

movement in individuals with paralysis or provide devices to assist
them, such as interfaces with computers or robot arms.

Researchers at Emory University in Atlanta, led by Philip Kennedy

and Roy Bakay, were first to install a brain implant in a human that
produced signals of high enough quality to simulate movement.
Their patient, Johnny Ray (1944–2002), suffered from 'locked-in
syndrome' after suffering a brain-stem stroke in 1997. Ray's implant
Dummy unit illustrating the design of
was installed in 1998 and he lived long enough to start working with
a BrainGate interface
the implant, eventually learning to control a computer cursor; he
died in 2002 of a brain aneurysm.[50]

Tetraplegic Matt Nagle became the first person to control an artificial hand using a BCI in 2005 as part
of the first nine-month human trial of Cyberkinetics's BrainGate chip-implant. Implanted in Nagle's
right precentral gyrus (area of the motor cortex for arm movement), the 96-electrode BrainGate implant
allowed Nagle to control a robotic arm by thinking about moving his hand as well as a computer cursor,
lights and TV.[51] One year later, professor Jonathan Wolpaw received the prize of the Altran Foundation
for Innovation to develop a Brain Computer Interface with electrodes located on the surface of the skull,
instead of directly in the brain.

More recently, research teams led by the Braingate group at Brown University[52] and a group led by
University of Pittsburgh Medical Center,[53] both in collaborations with the United States Department of
Veterans Affairs, have demonstrated further success in direct control of robotic prosthetic limbs with
many degrees of freedom using direct connections to arrays of neurons in the motor cortex of patients
with tetraplegia.

Partially invasive BCIs

Partially invasive BCI devices are implanted inside the skull but rest outside the brain rather than within
the grey matter. They produce better resolution signals than non-invasive BCIs where the bone tissue of
the cranium deflects and deforms signals and have a lower risk of forming scar-tissue in the brain than
fully invasive BCIs. There has been preclinical demonstration of intracortical BCIs from the stroke
perilesional cortex.[54]

Electrocorticography (ECoG) measures the electrical activity of the brain taken from beneath the skull
in a similar way to non-invasive electroencephalography, but the electrodes are embedded in a thin
plastic pad that is placed above the cortex, beneath the dura mater.[55] ECoG technologies were first
trialled in humans in 2004 by Eric Leuthardt and Daniel Moran from Washington University in St Louis.
In a later trial, the researchers enabled a teenage boy to play Space Invaders using his ECoG implant.[56]
This research indicates that control is rapid, requires minimal training, and may be an ideal tradeoff
with regards to signal fidelity and level of invasiveness.[note 1]

Signals can be either subdural or epidural, but are not taken from within the brain parenchyma itself. It
has not been studied extensively until recently due to the limited access of subjects. Currently, the only
manner to acquire the signal for study is through the use of patients requiring invasive monitoring for
localization and resection of an epileptogenic focus.

ECoG is a very promising intermediate BCI modality because it has higher spatial resolution, better
signal-to-noise ratio, wider frequency range, and less training requirements than scalp-recorded EEG,
and at the same time has lower technical difficulty, lower clinical risk, and probably superior long-term
stability than intracortical single-neuron recording. This feature profile and recent evidence of the high
level of control with minimal training requirements shows potential for real world application for people
with motor disabilities.[58][59]

Light reactive imaging BCI devices are still in the realm of theory. These would involve implanting a laser
inside the skull. The laser would be trained on a single neuron and the neuron's reflectance measured by
a separate sensor. When the neuron fires, the laser light pattern and wavelengths it reflects would
change slightly. This would allow researchers to monitor single neurons but require less contact with
tissue and reduce the risk of scar-tissue build-up.

Non-invasive BCIs

There have also been experiments in humans using non-invasive neuroimaging technologies as
interfaces. The substantial majority of published BCI work involves noninvasive EEG-based BCIs.
Noninvasive EEG-based technologies and interfaces have been used for a much broader variety of
applications. Although EEG-based interfaces are easy to wear and do not require surgery, they have
relatively poor spatial resolution and cannot effectively use higher-frequency signals because the skull
dampens signals, dispersing and blurring the electromagnetic waves created by the neurons. EEG-based
interfaces also require some time and effort prior to each usage session, whereas non-EEG-based ones,
as well as invasive ones require no prior-usage training. Overall, the best BCI for each user depends on
numerous factors.

Non-EEG-based human–computer interface

Electrooculography (EOG)

In 1989 report was given on control of a mobile robot by eye movement using Electrooculography (EOG)
signals. A mobile robot was driven from a start to a goal point using five EOG commands, interpreted as
forward, backward, left, right, and stop.[60] The EOG as a challenge of controlling external objects was
presented by Vidal in his 1973 paper.[2]

Pupil-size oscillation

A 2016 article[61] described an entirely new communication device and non-EEG-based human-
computer interface, which requires no visual fixation, or ability to move the eyes at all. The interface is
based on covert interest; directing one's attention to a chosen letter on a virtual keyboard, without the
need to move one's eyes to look directly at the letter. Each letter has its own (background) circle which
micro-oscillates in brightness differently from all of the other letters. The letter selection is based on best
fit between unintentional pupil-size oscillation and the background circle's brightness oscillation
pattern. Accuracy is additionally improved by the user's mental rehearsing of the words 'bright' and
'dark' in synchrony with the brightness transitions of the letter's circle.

Functional near-infrared spectroscopy

In 2014 and 2017, a BCI using functional near-infrared spectroscopy for "locked-in" patients with
amyotrophic lateral sclerosis (ALS) was able to restore some basic ability of the patients to communicate
with other people.[62][63]

Electroencephalography (EEG)-based brain-computer interfaces

Overview

After the BCI challenge was stated by Vidal in 1973, the initial
reports on non-invasive approach included control of a cursor in 2D
using VEP (Vidal 1977), control of a buzzer using CNV (Bozinovska
et al. 1988, 1990), control of a physical object, a robot, using a brain
rhythm (alpha) (Bozinovski et al. 1988), control of a text written on a
screen using P300 (Farwell and Donchin, 1988).[64]

In the early days of BCI research, another substantial barrier to

using Electroencephalography (EEG) as a brain–computer interface
was the extensive training required before users can work the Recordings of brainwaves produced
by an electroencephalogram
technology. For example, in experiments beginning in the mid-
1990s, Niels Birbaumer at the University of Tübingen in Germany
trained severely paralysed people to self-regulate the slow cortical
potentials in their EEG to such an extent that these signals could be used as a binary signal to control a
computer cursor.[65] (Birbaumer had earlier trained epileptics to prevent impending fits by controlling
this low voltage wave.) The experiment saw ten patients trained to move a computer cursor by
controlling their brainwaves. The process was slow, requiring more than an hour for patients to write
100 characters with the cursor, while training often took many months. However, the slow cortical
potential approach to BCIs has not been used in several years, since other approaches require little or no
training, are faster and more accurate, and work for a greater proportion of users.

Another research parameter is the type of oscillatory activity that is measured. Gert Pfurtscheller
founded the BCI Lab 1991 and fed his research results on motor imagery in the first online BCI based on
oscillatory features and classifiers. Together with Birbaumer and Jonathan Wolpaw at New York State
University they focused on developing technology that would allow users to choose the brain signals they
found easiest to operate a BCI, including mu and beta rhythms.

A further parameter is the method of feedback used and this is shown in studies of P300 signals.
Patterns of P300 waves are generated involuntarily (stimulus-feedback) when people see something they
recognize and may allow BCIs to decode categories of thoughts without training patients first. By
contrast, the biofeedback methods described above require learning to control brainwaves so the
resulting brain activity can be detected.
In 2005 it was reported research on EEG emulation of digital control circuits for BCI, with example of a
CNV flip-flop.[66] In 2009 it was reported noninvasive EEG control of a robotic arm using a CNV flip-
flop.[67] In 2011 it was reported control of two robotic arms solving Tower of Hanoi task with three disks
using a CNV flip-flop.[68] In 2015 it was described EEG-emulation of a Schmidt trigger, flip-flop,
demultiplexer, and modem.[69]

While an EEG based brain-computer interface has been pursued extensively by a number of research
labs, recent advancements made by Bin He and his team at the University of Minnesota suggest the
potential of an EEG based brain-computer interface to accomplish tasks close to invasive brain-
computer interface. Using advanced functional neuroimaging including BOLD functional MRI and EEG
source imaging, Bin He and co-workers identified the co-variation and co-localization of
electrophysiological and hemodynamic signals induced by motor imagination.[70] Refined by a
neuroimaging approach and by a training protocol, Bin He and co-workers demonstrated the ability of a
non-invasive EEG based brain-computer interface to control the flight of a virtual helicopter in 3-
dimensional space, based upon motor imagination.[71] In June 2013 it was announced that Bin He had
developed the technique to enable a remote-control helicopter to be guided through an obstacle
course.[72]

In addition to a brain-computer interface based on brain waves, as recorded from scalp EEG electrodes,
Bin He and co-workers explored a virtual EEG signal-based brain-computer interface by first solving the
EEG inverse problem and then used the resulting virtual EEG for brain-computer interface tasks. Well-
controlled studies suggested the merits of such a source analysis based brain-computer interface.[73]

A 2014 study found that severely motor-impaired patients could communicate faster and more reliably
with non-invasive EEG BCI, than with any muscle-based communication channel.[74]

A 2016 study found that the Emotiv EPOC device may be more suitable for control tasks using the
attention/meditation level or eye blinking than the Neurosky MindWave device.[75]

A 2019 study found that the application of evolutionary algorithms could improve EEG mental state
classification with a non-invasive Muse (headband) device, enabling high quality classification of data
acquired by a cheap consumer-grade EEG sensing device.[76]

Dry active electrode arrays

In the early 1990s Babak Taheri, at University of California, Davis demonstrated the first single and also
multichannel dry active electrode arrays using micro-machining. The single channel dry EEG electrode
construction and results were published in 1994.[77] The arrayed electrode was also demonstrated to
perform well compared to silver/silver chloride electrodes. The device consisted of four sites of sensors
with integrated electronics to reduce noise by impedance matching. The advantages of such electrodes
are: (1) no electrolyte used, (2) no skin preparation, (3) significantly reduced sensor size, and (4)
compatibility with EEG monitoring systems. The active electrode array is an integrated system made of
an array of capacitive sensors with local integrated circuitry housed in a package with batteries to power
the circuitry. This level of integration was required to achieve the functional performance obtained by
the electrode.

The electrode was tested on an electrical test bench and on human subjects in four modalities of EEG
activity, namely: (1) spontaneous EEG, (2) sensory event-related potentials, (3) brain stem potentials,
and (4) cognitive event-related potentials. The performance of the dry electrode compared favorably
with that of the standard wet electrodes in terms of skin preparation, no gel requirements (dry), and
higher signal-to-noise ratio.[78]
In 1999 researchers at Case Western Reserve University, in Cleveland, Ohio, led by Hunter Peckham,
used 64-electrode EEG skullcap to return limited hand movements to quadriplegic Jim Jatich. As Jatich
concentrated on simple but opposite concepts like up and down, his beta-rhythm EEG output was
analysed using software to identify patterns in the noise. A basic pattern was identified and used to
control a switch: Above average activity was set to on, below average off. As well as enabling Jatich to
control a computer cursor the signals were also used to drive the nerve controllers embedded in his
hands, restoring some movement.[79]

SSVEP mobile EEG BCIs

In 2009, the NCTU Brain-Computer-Interface-headband was reported. The researchers who developed
this BCI-headband also engineered silicon-based MicroElectro-Mechanical System (MEMS) dry
electrodes designed for application in non-hairy sites of the body. These electrodes were secured to the
DAQ board in the headband with snap-on electrode holders. The signal processing module measured
alpha activity and the Bluetooth enabled phone assessed the patients' alertness and capacity for cognitive
performance. When the subject became drowsy, the phone sent arousing feedback to the operator to
rouse them. This research was supported by the National Science Council, Taiwan, R.O.C., NSC, National
Chiao-Tung University, Taiwan's Ministry of Education, and the U.S. Army Research Laboratory.[80]

In 2011, researchers reported a cellular based BCI with the capability of taking EEG data and converting
it into a command to cause the phone to ring. This research was supported in part by Abraxis Bioscience
LLP, the U.S. Army Research Laboratory, and the Army Research Office. The developed technology was
a wearable system composed of a four channel bio-signal acquisition/amplification module, a wireless
transmission module, and a Bluetooth enabled cell phone. The electrodes were placed so that they pick
up steady state visual evoked potentials (SSVEPs).[81] SSVEPs are electrical responses to flickering visual
stimuli with repetition rates over 6 Hz[81] that are best found in the parietal and occipital scalp regions of
the visual cortex.[82] It was reported that with this BCI setup, all study participants were able to initiate
the phone call with minimal practice in natural environments.[83]

The scientists claim that their studies using a single channel fast Fourier transform (FFT) and multiple
channel system canonical correlation analysis (CCA) algorithm support the capacity of mobile
BCIs.[81][84] The CCA algorithm has been applied in other experiments investigating BCIs with claimed
high performance in accuracy as well as speed.[85] While the cellular based BCI technology was
developed to initiate a phone call from SSVEPs, the researchers said that it can be translated for other
applications, such as picking up sensorimotor mu/beta rhythms to function as a motor-imagery based
BCI.[81]

In 2013, comparative tests were performed on android cell phone, tablet, and computer based BCIs,
analyzing the power spectrum density of resultant EEG SSVEPs. The stated goals of this study, which
involved scientists supported in part by the U.S. Army Research Laboratory, were to "increase the
practicability, portability, and ubiquity of an SSVEP-based BCI, for daily use". Citation It was reported
that the stimulation frequency on all mediums was accurate, although the cell phone's signal
demonstrated some instability. The amplitudes of the SSVEPs for the laptop and tablet were also
reported to be larger than those of the cell phone. These two qualitative characterizations were suggested
as indicators of the feasibility of using a mobile stimulus BCI.[84]

Limitations

In 2011, researchers stated that continued work should address ease of use, performance robustness,
reducing hardware and software costs.[81]
One of the difficulties with EEG readings is the large susceptibility to motion artifacts.[86] In most the
previously described research projects, the participants were asked to sit still, reducing head and eye
movements as much as possible, and measurements were taken in a laboratory setting. However, since
the emphasized application of these initiatives had been in creating a mobile device for daily use,[84] the
technology had to be tested in motion.

In 2013, researchers tested mobile EEG-based BCI technology, measuring SSVEPs from participants as
they walked on a treadmill at varying speeds. This research was supported by the Office of Naval
Research, Army Research Office, and the U.S. Army Research Laboratory. Stated results were that as
speed increased the SSVEP detectability using CCA decreased. As independent component analysis
(ICA) had been shown to be efficient in separating EEG signals from noise,[87] the scientists applied ICA
to CCA extracted EEG data. They stated that the CCA data with and without ICA processing were similar.
Thus, they concluded that CCA independently demonstrated a robustness to motion artifacts that
indicates it may be a beneficial algorithm to apply to BCIs used in real world conditions.[82]

In 2020, researchers from the University of California used a computing system related to "brain-
machine interfaces" (BMIs) to translate brainwaves into sentences. However, their decoding was limited
to 30–50 sentences, even though the word error rates were as low as 3%.[88]

Prosthesis and environment control

Non-invasive BCIs have also been applied to enable brain-control of prosthetic upper and lower
extremity devices in people with paralysis. For example, Gert Pfurtscheller of Graz University of
Technology and colleagues demonstrated a BCI-controlled functional electrical stimulation system to
restore upper extremity movements in a person with tetraplegia due to spinal cord injury.[89] Between
2012 and 2013, researchers at the University of California, Irvine demonstrated for the first time that it
is possible to use BCI technology to restore brain-controlled walking after spinal cord injury. In their
spinal cord injury research study, a person with paraplegia was able to operate a BCI-robotic gait
orthosis to regain basic brain-controlled ambulation.[90][91] In 2009 Alex Blainey, an independent
researcher based in the UK, successfully used the Emotiv EPOC to control a 5 axis robot arm.[92] He then
went on to make several demonstration mind controlled wheelchairs and home automation that could be
operated by people with limited or no motor control such as those with paraplegia and cerebral palsy.

Research into military use of BCIs funded by DARPA has been ongoing since the 1970s.[2][3] The current
focus of research is user-to-user communication through analysis of neural signals.[93]

DIY and open source BCI

In 2001, The OpenEEG Project[94] was initiated by a group of DIY neuroscientists and engineers. The
ModularEEG was the primary device created by the OpenEEG community; it was a 6-channel signal
capture board that cost between $200 and $400 to make at home. The OpenEEG Project marked a
significant moment in the emergence of DIY brain-computer interfacing.

In 2010, the Frontier Nerds of NYU's ITP program published a thorough tutorial titled How To Hack Toy
EEGs.[95] The tutorial, which stirred the minds of many budding DIY BCI enthusiasts, demonstrated
how to create a single channel at-home EEG with an Arduino and a Mattel Mindflex at a very reasonable
price. This tutorial amplified the DIY BCI movement.
In 2013, OpenBCI emerged from a DARPA solicitation and subsequent Kickstarter campaign. They
created a high-quality, open-source 8-channel EEG acquisition board, known as the 32bit Board, that
retailed for under $500. Two years later they created the first 3D-printed EEG Headset, known as the
Ultracortex, as well as a 4-channel EEG acquisition board, known as the Ganglion Board, that retailed
for under $100.

MEG and MRI

Magnetoencephalography (MEG) and functional magnetic

resonance imaging (fMRI) have both been used successfully as non-
invasive BCIs.[96] In a widely reported experiment, fMRI allowed
two users being scanned to play Pong in real-time by altering their
haemodynamic response or brain blood flow through biofeedback
techniques.[97]

fMRI measurements of haemodynamic responses in real time have

also been used to control robot arms with a seven-second delay
between thought and movement.[98] ATR Labs' reconstruction of human
vision using fMRI (top row: original
In 2008 research developed in the Advanced Telecommunications image; bottom row: reconstruction
Research (ATR) Computational Neuroscience Laboratories in Kyoto, from mean of combined readings)
Japan, allowed the scientists to reconstruct images directly from the
brain and display them on a computer in black and white at a
resolution of 10x10 pixels. The article announcing these achievements was the cover story of the journal
Neuron of 10 December 2008.[99]

In 2011 researchers from UC Berkeley published[100] a study reporting second-by-second reconstruction

of videos watched by the study's subjects, from fMRI data. This was achieved by creating a statistical
model relating visual patterns in videos shown to the subjects, to the brain activity caused by watching
the videos. This model was then used to look up the 100 one-second video segments, in a database of 18
million seconds of random YouTube videos, whose visual patterns most closely matched the brain
activity recorded when subjects watched a new video. These 100 one-second video extracts were then
combined into a mashed-up image that resembled the video being watched.[101][102][103]

BCI control strategies in neurogaming

Motor imagery

Motor imagery involves the imagination of the movement of various body parts resulting in
sensorimotor cortex activation, which modulates sensorimotor oscillations in the EEG. This can be
detected by the BCI to infer a user's intent. Motor imagery typically requires a number of sessions of
training before acceptable control of the BCI is acquired. These training sessions may take a number of
hours over several days before users can consistently employ the technique with acceptable levels of
precision. Regardless of the duration of the training session, users are unable to master the control
scheme. This results in very slow pace of the gameplay.[104] Advanced machine learning methods were
recently developed to compute a subject-specific model for detecting the performance of motor imagery.
The top performing algorithm from BCI Competition IV[105] dataset 2 for motor imagery is the Filter
Bank Common Spatial Pattern, developed by Ang et al. from A*STAR, Singapore).[106]
Bio/neurofeedback for passive BCI designs

Biofeedback is used to monitor a subject's mental relaxation. In some cases, biofeedback does not
monitor electroencephalography (EEG), but instead bodily parameters such as electromyography
(EMG), galvanic skin resistance (GSR), and heart rate variability (HRV). Many biofeedback systems are
used to treat certain disorders such as attention deficit hyperactivity disorder (ADHD), sleep problems in
children, teeth grinding, and chronic pain. EEG biofeedback systems typically monitor four different
bands (theta: 4–7 Hz, alpha:8–12 Hz, SMR: 12–15 Hz, beta: 15–18 Hz) and challenge the subject to
control them. Passive BCI[42] involves using BCI to enrich human–machine interaction with implicit
information on the actual user's state, for example, simulations to detect when users intend to push
brakes during an emergency car stopping procedure. Game developers using passive BCIs need to
acknowledge that through repetition of game levels the user's cognitive state will change or adapt.
Within the first play of a level, the user will react to things differently from during the second play: for
example, the user will be less surprised at an event in the game if he/she is expecting it.[104]

Visual evoked potential (VEP)

A VEP is an electrical potential recorded after a subject is presented with a type of visual stimuli. There
are several types of VEPs.

Steady-state visually evoked potentials (SSVEPs) use potentials generated by exciting the retina, using
visual stimuli modulated at certain frequencies. SSVEP's stimuli are often formed from alternating
checkerboard patterns and at times simply use flashing images. The frequency of the phase reversal of
the stimulus used can be clearly distinguished in the spectrum of an EEG; this makes detection of SSVEP
stimuli relatively easy. SSVEP has proved to be successful within many BCI systems. This is due to
several factors, the signal elicited is measurable in as large a population as the transient VEP and blink
movement and electrocardiographic artefacts do not affect the frequencies monitored. In addition, the
SSVEP signal is exceptionally robust; the topographic organization of the primary visual cortex is such
that a broader area obtains afferents from the central or fovial region of the visual field. SSVEP does
have several problems however. As SSVEPs use flashing stimuli to infer a user's intent, the user must
gaze at one of the flashing or iterating symbols in order to interact with the system. It is, therefore, likely
that the symbols could become irritating and uncomfortable to use during longer play sessions, which
can often last more than an hour which may not be an ideal gameplay.

Another type of VEP used with applications is the P300 potential. The P300 event-related potential is a
positive peak in the EEG that occurs at roughly 300 ms after the appearance of a target stimulus (a
stimulus for which the user is waiting or seeking) or oddball stimuli. The P300 amplitude decreases as
the target stimuli and the ignored stimuli grow more similar.The P300 is thought to be related to a
higher level attention process or an orienting response using P300 as a control scheme has the
advantage of the participant only having to attend limited training sessions. The first application to use
the P300 model was the P300 matrix. Within this system, a subject would choose a letter from a grid of
6 by 6 letters and numbers. The rows and columns of the grid flashed sequentially and every time the
selected "choice letter" was illuminated the user's P300 was (potentially) elicited. However, the
communication process, at approximately 17 characters per minute, was quite slow. The P300 is a BCI
that offers a discrete selection rather than a continuous control mechanism. The advantage of P300 use
within games is that the player does not have to teach himself/herself how to use a completely new
control system and so only has to undertake short training instances, to learn the gameplay mechanics
and basic use of the BCI paradigm.[104]

Synthetic telepathy/silent communication

In a $6.3 million Army initiative to invent devices for telepathic communication, Gerwin Schalk,
underwritten in a $2.2 million grant, found the use of ECoG signals can discriminate the vowels and
consonants embedded in spoken and imagined words, shedding light on the distinct mechanisms
associated with production of vowels and consonants, and could provide the basis for brain-based
communication using imagined speech.[59][107]

In 2002 Kevin Warwick had an array of 100 electrodes fired into his nervous system in order to link his
nervous system into the Internet to investigate enhancement possibilities. With this in place Warwick
successfully carried out a series of experiments. With electrodes also implanted into his wife's nervous
system, they conducted the first direct electronic communication experiment between the nervous
systems of two humans.[108][109][110][111]

Another group of researchers was able to achieve conscious brain-to-brain communication between two
people separated by a distance using non-invasive technology that was in contact with the scalp of the
participants. The words were encoded by binary streams using the sequences of 0's and 1's by the
imaginary motor input of the person "emitting" the information. As the result of this experiment,
pseudo-random bits of the information carried encoded words “hola” (“hi” in Spanish) and “ciao” (“hi”
or “goodbye in Italian) and were transmitted mind-to-mind between humans separated by a distance,
with blocked motor and sensory systems, which has little to no probability of this happening by chance.
[2] (https://doi.org/10.1371/journal.pone.0105225)

Research into synthetic telepathy using subvocalization is taking place at the University of California,
Irvine under lead scientist Mike D'Zmura. The first such communication took place in the 1960s using
EEG to create Morse code using brain alpha waves. Using EEG to communicate imagined speech is less
accurate than the invasive method of placing an electrode between the skull and the brain.[112] On 27
February 2013 the group with Miguel Nicolelis at Duke University and IINN-ELS successfully connected
the brains of two rats with electronic interfaces that allowed them to directly share information, in the
first-ever direct brain-to-brain interface.[113][114][115]

Cell-culture BCIs
Researchers have built devices to interface with neural cells and entire neural networks in cultures
outside animals. As well as furthering research on animal implantable devices, experiments on cultured
neural tissue have focused on building problem-solving networks, constructing basic computers and
manipulating robotic devices. Research into techniques for stimulating and recording from individual
neurons grown on semiconductor chips is sometimes referred to as neuroelectronics or neurochips.[116]

Development of the first working neurochip was claimed by a Caltech team

led by Jerome Pine and Michael Maher in 1997.[117] The Caltech chip had
room for 16 neurons.

In 2003 a team led by Theodore Berger, at the University of Southern

California, started work on a neurochip designed to function as an artificial
or prosthetic hippocampus. The neurochip was designed to function in rat
brains and was intended as a prototype for the eventual development of
higher-brain prosthesis. The hippocampus was chosen because it is thought
The world's first Neurochip,
to be the most ordered and structured part of the brain and is the most developed by Caltech
studied area. Its function is to encode experiences for storage as long-term researchers Jerome Pine
memories elsewhere in the brain.[118] and Michael Maher
In 2004 Thomas DeMarse at the University of Florida used a culture of 25,000 neurons taken from a
rat's brain to fly a F-22 fighter jet aircraft simulator.[119] After collection, the cortical neurons were
cultured in a petri dish and rapidly began to reconnect themselves to form a living neural network. The
cells were arranged over a grid of 60 electrodes and used to control the pitch and yaw functions of the
simulator. The study's focus was on understanding how the human brain performs and learns
computational tasks at a cellular level.

Ethical considerations
Sources:[120][121][122][123][124]

User-centric issues
Long-term effects to the user remain largely unknown.
Obtaining informed consent from people who have difficulty communicating.
The consequences of BCI technology for the quality of life of patients and their families.
Health-related side-effects (e.g. neurofeedback of sensorimotor rhythm training is reported to affect
sleep quality).
Therapeutic applications and their potential misuse.
Safety risks
Non-convertibility of some of the changes made to the brain

Legal and social

Issues of accountability and responsibility: claims that the influence of BCIs overrides free will and
control over sensory-motor actions, claims that cognitive intention was inaccurately translated due to
a BCI malfunction.
Personality changes involved caused by deep-brain stimulation.
Concerns regarding the state of becoming a "cyborg" - having parts of the body that are living and
parts that are mechanical.
Questions personality: what does it mean to be a human?
Blurring of the division between human and machine and inability to distinguish between human vs.
machine-controlled actions.
Use of the technology in advanced interrogation techniques by governmental authorities.
Selective enhancement and social stratification.
Questions of research ethics that arise when progressing from animal experimentation to application
in human subjects.
Moral questions
Mind reading and privacy.
Tracking and "tagging system"
Mind control.
Movement control
Emotion control

In their current form, most BCIs are far removed from the ethical issues considered above. They are
actually similar to corrective therapies in function. Clausen stated in 2009 that "BCIs pose ethical
challenges, but these are conceptually similar to those that bioethicists have addressed for other realms
of therapy".[120] Moreover, he suggests that bioethics is well-prepared to deal with the issues that arise
with BCI technologies. Haselager and colleagues[121] pointed out that expectations of BCI efficacy and
value play a great role in ethical analysis and the way BCI scientists should approach media.
Furthermore, standard protocols can be implemented to ensure ethically sound informed-consent
procedures with locked-in patients.

The case of BCIs today has parallels in medicine, as will its evolution. Similar to how pharmaceutical
science began as a balance for impairments and is now used to increase focus and reduce need for sleep,
BCIs will likely transform gradually from therapies to enhancements.[123] Efforts are made inside the
BCI community to create consensus on ethical guidelines for BCI research, development and
dissemination.[124]

Low-cost BCI-based interfaces

Recently a number of companies have scaled back medical grade EEG technology (and in one case,
NeuroSky, rebuilt the technology from the ground up) to create inexpensive BCIs. This technology has
been built into toys and gaming devices; some of these toys have been extremely commercially successful
like the NeuroSky and Mattel MindFlex.

In 2006 Sony patented a neural interface system allowing radio waves to affect signals in the neural
cortex.[125]
In 2007 NeuroSky released the first affordable consumer based EEG along with the game NeuroBoy.
This was also the first large scale EEG device to use dry sensor technology.[126]
In 2008 OCZ Technology developed a device for use in video games relying primarily on
electromyography.[127]
In 2008 Final Fantasy developer Square Enix announced that it was partnering with NeuroSky to
create a game, Judecca.[128][129]
In 2009 Mattel partnered with NeuroSky to release the Mindflex, a game that used an EEG to steer a
ball through an obstacle course. It is by far the best selling consumer based EEG to date.[128][130]
In 2009 Uncle Milton Industries partnered with NeuroSky to release the Star Wars Force Trainer, a
game designed to create the illusion of possessing the Force .[128][131]
In 2009 Emotiv released the EPOC, a 14 channel EEG device that can read 4 mental states, 13
conscious states, facial expressions, and head movements. The EPOC is the first commercial BCI to
use dry sensor technology, which can be dampened with a saline solution for a better
connection.[132]
In November 2011 Time Magazine selected "necomimi" produced by Neurowear as one of the best
inventions of the year. The company announced that it expected to launch a consumer version of the
garment, consisting of cat-like ears controlled by a brain-wave reader produced by NeuroSky, in
spring 2012.[133]
In February 2014 They Shall Walk (a nonprofit organization fixed on constructing exoskeletons,
dubbed LIFESUITs, for paraplegics and quadriplegics) began a partnership with James W. Shakarji
on the development of a wireless BCI.[134]
In 2016, a group of hobbyists developed an open-source BCI board that sends neural signals to the
audio jack of a smartphone, dropping the cost of entry-level BCI to £20.[135] Basic diagnostic
software is available for Android devices, as well as a text entry app for Unity.[136]

Future directions
A consortium consisting of 12 European partners has completed a
roadmap to support the European Commission in their funding
decisions for the new framework program Horizon 2020. The
project, which was funded by the European Commission, started in
November 2013 and published a roadmap in April 2015.[137] A 2015
publication led by Dr. Clemens Brunner describes some of the
analyses and achievements of this project, as well as the emerging
Brain-Computer Interface Society.[138] For example, this article
reviewed work within this project that further defined BCIs and
applications, explored recent trends, discussed ethical issues, and
evaluated different directions for new BCIs. As the article notes,
their new roadmap generally extends and supports the Brain-computer interface
recommendations from the Future BNCI project managed by Dr.
Brendan Allison, which conveys substantial enthusiasm for
emerging BCI directions.

Other recent publications too have explored future BCI directions for new groups of disabled users
(e.g.,[9][139][140][141][142]). Some prominent examples are summarized below.

Disorders of consciousness (DOC)

Some persons have a disorder of consciousness (DOC). This state is defined to include persons with
coma, as well as persons in a vegetative state (VS) or minimally conscious state (MCS). New BCI research
seeks to help persons with DOC in different ways. A key initial goal is to identify patients who are able to
perform basic cognitive tasks, which would of course lead to a change in their diagnosis. That is, some
persons who are diagnosed with DOC may in fact be able to process information and make important life
decisions (such as whether to seek therapy, where to live, and their views on end-of-life decisions
regarding them). Some persons who are diagnosed with DOC die as a result of end-of-life decisions,
which may be made by family members who sincerely feel this is in the patient's best interests. Given the
new prospect of allowing these patients to provide their views on this decision, there would seem to be a
strong ethical pressure to develop this research direction to guarantee that DOC patients are given an
opportunity to decide whether they want to live.[143][144]

These and other articles describe new challenges and solutions to use BCI technology to help persons
with DOC. One major challenge is that these patients cannot use BCIs based on vision. Hence, new tools
rely on auditory and/or vibrotactile stimuli. Patients may wear headphones and/or vibrotactile
stimulators placed on the wrists, neck, leg, and/or other locations. Another challenge is that patients
may fade in and out of consciousness, and can only communicate at certain times. This may indeed be a
cause of mistaken diagnosis. Some patients may only be able to respond to physicians' requests during a
few hours per day (which might not be predictable ahead of time) and thus may have been unresponsive
during diagnosis. Therefore, new methods rely on tools that are easy to use in field settings, even without
expert help, so family members and other persons without any medical or technical background can still
use them. This reduces the cost, time, need for expertise, and other burdens with DOC assessment.
Automated tools can ask simple questions that patients can easily answer, such as "Is your father named
George?" or "Were you born in the USA?" Automated instructions inform patients that they may convey
yes or no by (for example) focusing their attention on stimuli on the right vs. left wrist. This focused
attention produces reliable changes in EEG patterns that can help determine that the patient is able to
communicate. The results could be presented to physicians and therapists, which could lead to a revised
diagnosis and therapy. In addition, these patients could then be provided with BCI-based
communication tools that could help them convey basic needs, adjust bed position and HVAC (heating,
ventilation, and air conditioning), and otherwise empower them to make major life decisions and
communicate.[145][146][147]

Motor recovery

People may lose some of their ability to move due to many causes, such as stroke or injury. Several
groups have explored systems and methods for motor recovery that include BCIs.[148][149][150][151] In this
approach, a BCI measures motor activity while the patient imagines or attempts movements as directed
by a therapist. The BCI may provide two benefits: (1) if the BCI indicates that a patient is not imagining a
movement correctly (non-compliance), then the BCI could inform the patient and therapist; and (2)
rewarding feedback such as functional stimulation or the movement of a virtual avatar also depends on
the patient's correct movement imagery.

So far, BCIs for motor recovery have relied on the EEG to measure the patient's motor imagery.
However, studies have also used fMRI to study different changes in the brain as persons undergo BCI-
based stroke rehab training.[152][153] Future systems might include the fMRI and other measures for
real-time control, such as functional near-infrared, probably in tandem with EEGs. Non-invasive brain
stimulation has also been explored in combination with BCIs for motor recovery.[154] In 2016, scientists
out of the University of Melbourne published preclinical proof-of-concept data related to a potential
brain-computer interface technology platform being developed for patients with paralysis to facilitate
control of external devices such as robotic limbs, computers and exoskeletons by translating brain
activity.[155][156] Clinical trials are currently underway.[157]

Functional brain mapping

Each year, about 400,000 people undergo brain mapping during neurosurgery. This procedure is often
required for people with tumors or epilepsy that do not respond to medication.[158] During this
procedure, electrodes are placed on the brain to precisely identify the locations of structures and
functional areas. Patients may be awake during neurosurgery and asked to perform certain tasks, such as
moving fingers or repeating words. This is necessary so that surgeons can remove only the desired tissue
while sparing other regions, such as critical movement or language regions. Removing too much brain
tissue can cause permanent damage, while removing too little tissue can leave the underlying condition
untreated and require additional neurosurgery. Thus, there is a strong need to improve both methods
and systems to map the brain as effectively as possible.

In several recent publications, BCI research experts and medical doctors have collaborated to explore
new ways to use BCI technology to improve neurosurgical mapping. This work focuses largely on high
gamma activity, which is difficult to detect with non-invasive means. Results have led to improved
methods for identifying key areas for movement, language, and other functions. A recent article
addressed advances in functional brain mapping and summarizes a workshop.[159]

Flexible devices

Flexible electronics are polymers or other flexible materials (e.g. silk,[160] pentacene, PDMS, Parylene,
polyimide[161]) that are printed with circuitry; the flexible nature of the organic background materials
allowing the electronics created to bend, and the fabrication techniques used to create these devices
resembles those used to create integrated circuits and microelectromechanical systems (MEMS).
Flexible electronics were first developed in the 1960s and 1970s, but research interest increased in the
mid-2000s.[162]

Neural dust

Neural dust is a term used to refer to millimeter-sized devices operated as wirelessly powered nerve
sensors that were proposed in a 2011 paper from the University of California, Berkeley Wireless
Research Center, which described both the challenges and outstanding benefits of creating a long lasting
wireless BCI.[163][164] In one proposed model of the neural dust sensor, the transistor model allowed for
a method of separating between local field potentials and action potential "spikes", which would allow
for a greatly diversified wealth of data acquirable from the recordings.[163]

See also
Informatics Neuralink
Augmented learning Neurorobotics
Biological machine Neurostimulation
Cortical implants Nootropic
Deep brain stimulation Project Cyborg
Human senses Simulated reality
Kernel (neurotechnology company) Telepresence
Lie detection Thought identification
Microwave auditory effect Whole brain emulation
Neural engineering

Notes
1. These electrodes had not been implanted in the patient with the intention of developing a BCI. The
patient had been suffering from severe epilepsy and the electrodes were temporarily implanted to
help his physicians localize seizure foci; the BCI researchers simply took advantage of this.[57]

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Further reading
Brouse, Andrew. "A Young Person's Guide to Brainwave Music: Forty years of audio from the human
EEG (http://cec.sonus.ca/econtact/14_2/brouse_brainwavemusic.html)." eContact! 14.2 –
Biotechnological Performance Practice / Pratiques de performance biotechnologique (July 2012).
Montréal: CEC.
Gupta, Cota Navin and Ramaswamy Palanappian. "Using High-Frequency Electroencephalogram in
Visual and Auditory-Based Brain-Computer Interface Designs (http://cec.sonus.ca/econtact/14_2/gup
ta-palanappian_interfacedesign.html)." eContact! 14.2 – Biotechnological Performance Practice /
Pratiques de performance biotechnologique (July 2012). Montréal: CEC.
Ouzounian, Gascia. "The Biomuse Trio in Conversation: An Interview with R. Benjamin Knapp and
Eric Lyon (http://cec.sonus.ca/econtact/14_2/ouzounian_biomuse.html)." eContact! 14.2 –
Biotechnological Performance Practice / Pratiques de performance biotechnologique (July 2012).
Montréal: CEC.

External links
The Unlock Project (https://web.archive.org/web/20131117040218/http://unlockproject.org/)

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